ELEESA BLAKE MA, LMHC
NPI 1114367943
Counselor - Mental Health in Tacoma, WA

Active since June 25, 2013PECOS EnrolledAccepts Medicare Assignment
950 BROADWAY STE 404, TACOMA, WA 98402(425) 310-2508 Get Directions Write a Review

NPPES record last updated: March 11, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 11, 2025, Oct 13, 2021 (2 updates tracked since 2021).

About Eleesa Blake Ma, Lmhc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELEESA BLAKE MA, LMHC (NPI 1114367943) is an individual mental health provider in Tacoma, Washington, licensed in Washington (LH61173069) and active in the NPI registry since June 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1114367943
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameELEESA BLAKECredential: MA, LMHC
Location Address950 BROADWAY STE 404Tacoma, WA 98402-4454
Mailing Address950 Broadway Ste 404Tacoma, WA 98402-4454 · (425) 310-2508
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateJune 25, 2013
Last NPPES UpdateMarch 11, 20252 updates tracked since enumeration
NPPES CertifiedMarch 11, 2025
NPI 1114367943 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License Licensed in WA · LH61173069
950 BROADWAY STE 404, Tacoma, WA 98402

Other Names 1

Former Name (1)Eleesa Fluckiger

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Eleesa Blake Ma, Lmhc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789128562
PECOS Enrollment IDI20240703003029
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Psychiatric/Mental Health)
950 BROADWAY STE 404
TACOMA, WA 98402
Marriage & Family Therapist
950 BROADWAY STE 404
TACOMA, WA 98402
Social Worker (Clinical)
950 BROADWAY STE 404
TACOMA, WA 98402
Counselor (Mental Health)
950 BROADWAY STE 404
TACOMA, WA 98402
Social Worker (Clinical)
950 BROADWAY STE 404
TACOMA, WA 98402
Social Worker (Clinical)
950 BROADWAY STE 404
TACOMA, WA 98402
Social Worker (Clinical)
950 BROADWAY STE 404
TACOMA, WA 98402
Counselor (Mental Health)
950 BROADWAY STE 404
TACOMA, WA 98402

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114367943, enumerated as an "individual" on June 25, 2013.

The provider is located at 950 BROADWAY STE 404 TACOMA, WA 98402 and the phone number is (425) 310-2508.

Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

The provider might be accepting Accepts: Kaiser Permanente and Premera Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.